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1.  Acceptability of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy: Barriers and facilitators to PrEP uptake among at-risk Peruvian populations 
This study examined Pre-Exposure Prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons, and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, p <0.001), followed by efficacy (21.4, p <0.001) and potential side effects (14.7, p <0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out if proven efficacious in ongoing clinical trials.
PMCID: PMC3096991  PMID: 21571973
South America; HIV; MSM; FSW; PrEP Acceptability
2.  An Elective Course to Engage Student Pharmacists in Elementary School Science Education 
Objective. To develop and assess the impact of an elective course (HealthWISE) on student pharmacists’ skills in communication and health promotion and elementary school students’ knowledge of and attitudes toward science.
Design. Three colleges and schools of pharmacy collaborated to develop a 1-credit elective course that used online and classroom teaching and learning techniques to prepare student pharmacists to teach science in elementary school classrooms. Student pharmacists delivered 6 science lessons to elementary students over the course of 2 months.
Assessment. In weekly journal reflections and a final paper, student pharmacists reported improved communication and health promotion skills. Elementary teachers reported they were satisfied with student pharmacists’ performance in the classroom. On pretest and posttest evaluations, elementary students demonstrated increased science knowledge and enhanced enthusiasm for science following the lessons taught by student pharmacists.
Conclusions. The HealthWISE elective course provided positive benefit for student pharmacists, elementary school teachers, and elementary students.
PMCID: PMC3279034  PMID: 22345722
service-learning; communication skills; health promotion; STEM education
3.  The Impact of Acculturation on Utilization of HIV Prevention Services and Access to Care Among an at-Risk Hispanic Population 
HIV/AIDS disproportionately affects Hispanics in the United States, a diverse and heterogeneous population. The purpose of this study was to evaluate the relationship of acculturation with HIV and hepatitis C testing, and access to care among Hispanics at risk for HIV.
We recruited 600 Hispanics from STD clinics, community-based organizations, and needle exchange programs in Los Angeles County.
Low levels of acculturation were significantly associated with having fewer HIV tests (OR = 1.98; 95% CI = 1.24, 3.15), no hepatitis C tests (OR = 2.61; 95% CI = 1.77, 3.84), testing positive for HIV (OR = 2.67; 95% CI = 1.04, 6.83), and low levels of access to care (β = 0.06; p<.05).
Low levels of acculturation are an important barrier to the use of HIV-related health care services. Our findings may inform the development of effective interventions that address the cultural and behavioral differences among Hispanic subgroups.
PMCID: PMC2874820  PMID: 20168013
Acculturation; HIV; hepatitis C; access to care
4.  The Association of Stigma with Self-Reported Access to Medical Care and Antiretroviral Therapy Adherence in Persons Living with HIV/AIDS 
Journal of General Internal Medicine  2009;24(10):1101-1108.
The stigma of HIV-infection may profoundly affect the lives of persons living with HIV/AIDS (PLHA). However few studies have examined the association of HIV stigma with multiple components of HIV treatment and care.
To estimate the association between HIV stigma and: self-reported access to care, regular source of HIV care, and antiretroviral therapy adherence; and to test whether mental health mediates these associations.
Cross-sectional study.
202 PLHA living in Los Angeles County in 2007.
Participants completed an anonymous survey, assessing internalized HIV stigma (28-items, alpha = 0.93), self-reported access to medical care (six items, alpha = 0.75), regular source of HIV care, and antiretroviral therapy (ART) adherence.
One-third of participants reported high levels of stigma; 77% reported poor access to care; 42.5% reported suboptimal ART adherence; and 10.5% reported no regular source of HIV care. In unadjusted analysis, those reporting a high level of stigma were more likely to report poor access to care (OR = 4.97, 95% CI 2.54–9.72), regular source of HIV care (OR = 2.48, 95% CI 1.00–6.19), and ART adherence (OR = 2.45, 95% CI 1.23–4.91). In adjusted analyses, stigma was significantly associated with poor access to care (OR = 4.42, 95% CI 1.88–10.37), but not regular source of HIV care or ART adherence. Mental health mediated the relationship between stigma and ART adherence, but not poor access to care or regular source of HIV care.
The association of stigma with self-reported access to care and adherence suggests that efforts to improve these components of HIV care will require a better understanding of the possible effects of stigma and it′s mediators.
PMCID: PMC2762503  PMID: 19653047
HIV/AIDS; HIV; stigma; care; antiretroviral

Results 1-4 (4)